PJI within 1 year after THA may increase 10-year mortality risk among patients
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Key takeaways:
- Results showed periprosthetic joint infection after total hip arthroplasty was associated with an increased 10-year mortality risk.
- There was no association between mortality risk and postoperative pneumonia.
Results from a propensity-matched, retrospective cohort study showed periprosthetic joint infection within 1 year after total hip arthroplasty was associated with an almost 5.5 times increased 10-year mortality risk among patients.
“The results of this study build on previous evidence to help delineate the causal association between PJI and increased mortality risk,” the researchers wrote in the study. “These findings should help to bolster efforts related to the prevention, diagnosis and treatment of PJIs, which may be considered among the most important priorities for future musculoskeletal research.”
Researchers collected administrative health care data from the Institute for Clinical Evaluative Sciences on 175,432 adults who underwent primary THA. The primary study outcome was all-cause mortality within 10 years of the index THA procedure. Researchers performed propensity-matched analyses for patients with vs. without PJI within 1 year of THA. They also performed three sensitivity analyses: one for which patients were matched by primary surgeon for their index procedure, one for which patients aged 60 years or older were excluded and one to determine whether there was a relationship between pneumonia within 30 days postoperatively and mortality within 10 years.
Among the study population, 868 patients had surgery for a PJI of the replaced joint within 1 year of the index THA procedure. Researchers found a 10-year mortality rate of 11.4% in patients who had a PJI within 1 year of index THA compared with 2.2% in patients who did not have PJI.
In addition, researchers found patients who had a PJI also had a higher 10-year mortality rate than those who did not have PJI after matching to the same primary surgeon for the index THA procedure. The same was true after excluding for patients aged 60 years or older. Researchers found no significant association between postoperative pneumonia and 10-year mortality.
“The findings of the present study underscore the continued importance of identifying effective strategies for infection prevention and ensuring that operative teams adhere to best-practice guidelines,” the researchers wrote. “These findings also reinforce the need to delineate the best approaches to managing PJI, with strategies that not only focus on curing the infection but also consider patient morbidity and mortality.”
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